Bisphosphonate effects on events compared between cancer and healthy patients.

Just two studies of bisphosphonates for preventing osteoperosis in “healthy” women without cancer: FIT and Horizon.

The table below compares the odds ratios from the network meta-analysis of bisphosphonates in women with cancer with the equivalent odds ratios from a simple meta-analysis of HORIZON and FIT, for the events that are significant in the cancer analysis and also reported in HORIZON and FIT.

## Warning: Column `event` joining factors with different levels, coercing to character vector

## Warning: Column `event` joining character vector and factor, coercing into character vector

Treatment (cancer NMA)

OR (Cancer, NMA)

Treatment (healthy MA)

OR (healthy MA)

MYALGIA

MYALGIA

Ibandronate

2.04 (1.13, 3.85)

Bisphosphonate

5.99 (4.59, 7.81)

MYALGIA

Pamidronate

2.32 (1.09, 5.21)

Bisphosphonate

5.99 (4.59, 7.81)

MYALGIA

Zoledronic_acid

2.36 (1.61, 3.6)

Bisphosphonate

5.99 (4.59, 7.81)

OTHERS

ABDOMINAL PAIN

Bisphosphonate

1.51 (1.1, 2.11)

Bisphosphonate

1.11 (0.97, 1.27)

ARTHRALGIA

Nitrogenous

1.54 (1.28, 1.86)

Bisphosphonate

3.54 (2.74, 4.59)

CARDIAC EVENTS

Nitrogenous

2.73 (1.33, 6.31)

Bisphosphonate

1.29 (0.95, 1.76)

CARDIAC EVENTS

Non_nitrogenous

4.35 (1.44, 13.6)

Bisphosphonate

1.29 (0.95, 1.76)

CHILLS

Zoledronic_acid_IV

15.19 (3.96, 94.86)

Bisphosphonate

7.71 (4.98, 11.95)

DIARRHOEA

Non_nitrogenous

1.81 (1.35, 2.74)

Bisphosphonate

2.41 (1.48, 3.92)

FATIGUE

Bisphosphonate

1.28 (1.06, 1.65)

Bisphosphonate

3.37 (2.53, 4.49)

FEVER

Pamidronate_IV

4.87 (1.9, 12.62)

Bisphosphonate

10.11 (8.5, 12.01)

FEVER

Zoledronic_acid_IV

5.2 (2.88, 8.79)

Bisphosphonate

10.11 (8.5, 12.01)

HEADACHE

Zoledronic_acid

1.48 (1.06, 2.25)

Bisphosphonate

3.5 (2.9, 4.21)

Influenza-like symptoms

Bisphosphonate

16.09 (2.04, 207.85)

Bisphosphonate

5.86 (4.77, 7.19)

NAUSEA

Bisphosphonate

1.33 (1.11, 1.63)

Bisphosphonate

1.95 (1.57, 2.42)

THROMBOEMBOLIC EVENTS

Clodronate

7.27 (1.41, 33.44)

Bisphosphonate

0.99 (0.73, 1.33)

THROMBOEMBOLIC EVENTS

Ibandronate

13.15 (2.36, 68.93)

Bisphosphonate

0.99 (0.73, 1.33)

THROMBOEMBOLIC EVENTS

Zoledronic_acid

2.79 (0.99, 7.42)

Bisphosphonate

0.99 (0.73, 1.33)

VOMITING

Non_nitrogenous

1.67 (1.18, 2.92)

Bisphosphonate

12.35 (5.37, 28.42)

Events deemed significant in a fixed effects meta analysis of HORIZON/FIT, using same criterion as in the main analysis: statistically significant OR > 1.5 or risk difference > 0.02.

Odds ratio

Risk difference

NAUSEA

1.95 (1.57, 2.42)

0.01 (0.01, 0.01)

ARTHRALGIA

3.54 (2.74, 4.59)

0.02 (0.01, 0.02)

FEVER

10.11 (8.5, 12.01)

0.1 (0.1, 0.11)

HEADACHE

3.5 (2.9, 4.21)

0.03 (0.03, 0.04)

Influenza-like symptoms

5.86 (4.77, 7.19)

0.05 (0.04, 0.05)

MYALGIA

5.99 (4.59, 7.81)

0.03 (0.02, 0.03)

CHILLS

7.71 (4.98, 11.95)

0.01 (0.01, 0.02)

DEHYDRATION

23.01 (1.36, 390.54)

0 (0, 0)

DIARRHOEA

2.41 (1.48, 3.92)

0 (0, 0)

DIZZINESS

1.89 (1.28, 2.78)

0 (0, 0.01)

FATIGUE

3.37 (2.53, 4.49)

0.01 (0.01, 0.02)

HOT FLUSHES

2.7 (1.31, 5.6)

0 (0, 0)

LOSS OF APPETITE

6.48 (2.92, 14.38)

0 (0, 0)

MUSCULOSKELETAL PAIN/EVENT

4.97 (4.19, 5.88)

0.05 (0.05, 0.06)

Nasopharyngitis

3.4 (1.25, 9.23)

0 (0, 0)

OEDEMA

4.5 (1.52, 13.32)

0 (0, 0)

OTHER EYE DISORDERS

11.03 (2.59, 46.93)

0 (0, 0)

VOMITING

12.35 (5.37, 28.42)

0.01 (0, 0.01)

The study-specific odds ratios underlying these results are shown below.

For each event, the odds ratios from HORIZON and FIT are not surprising given the variability between studies.